Individual
AISHWARYA BHARATHI MALLELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9167 W FLAMINGO RD, LAS VEGAS, NV 89147-6472
(702) 565-1894
Mailing address
41 DOLLAR POINTE AVE, LAS VEGAS, NV 89148-2763
(702) 501-1545
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/19/2021
Last updated
03/19/2021
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